Cigarette smoking accelerates progression of renal failure in primary renal disease. A prospective study in parallel group design with matched groups

There is substantial evidence for the adverse impact of smoking on deterior ation of renal function in diabetic nephropathy but very little information is available concerning effects of smoking on the evolution of other renal diseases. In a prospective study in parallel group design with matched gro ups, 45 cigarette smoking patients (greater than or equal to 1 pack/day) wi th glomerular or tubulointerstitial lesions were compared with 45 non-smoki ng patients matched for age, gender, cause and severity of renal disease as well as presence of hypertension. The monthly decline of creatinine cleara nce was significantly faster in smoking patients than in non-smoking patien ts (follow-up period 2 years) (1.25 mL/min vs 0.67 mL/min, P < 0.001). Smok ing promoted progression of both glomerular and tubulointerstitial nephropa thy. This effect occurred independently of changes in blood pressure, prote inuria or lipid concentration. The results of this investigation indicate t hat cigarette smoking is an independent risk factor not only for diabetic b ut also for non-diabetic nephropathies.